Search

Background: To determine the effect of neuromuscular blocking agents following pre- treatment with magnesium sulphate, investigation was done on the mechanism of pre-treatment with MgSO4 potentiating the onset and recovery characteristics of cisatracurium. Materials and Methods: After approval from Institutional Review Board, 48 patients belonging to ASA I and II were divided into two groups. Patients of group M received MgSO4 30 mg/kg in 0.9% normal saline (total volume 100 ml), and patients of group C received 0.9% normal saline (control group) alone intravenously (IV) for 15 min before induction with propofol, remifentanil and cisatracurium 0.15 mg/kg. Then anaesthetic effect was maintained using propofol and remifentanil by train-of-four, and the electromyographical responses were measured. Lag time, onset time, total recovery time, clinical duration, recovery index, recovery time, mean arterial blood pressure, heart rate, and ionised magnesium were measured. Results: The lag time and onset time were significantly shorter in group M than in group C (p<0.05). But recovery index, recovery time, clinical duration, and total recovery time showed no notable differences when compared (p>0.05). At the time point immediately after the administration of MgSO4, Mean arterial pressure was more significantly increased in group M than the group C. In both groups, heart rate showed no significant changes. At all the time points, ionised magnesium concentrations significantly increased (p<0.05). Conclusion: The use of MgSO4 has resulted in a shortening of the onset time of about 29% of cisatracurium (0.15 mg/kg) and without any change in the recovery of neuromuscular block. [ABSTRACT FROM AUTHOR]

Background: Covid-19 ARDS is a common presentation in the emergency ward and needs quick assessment and treatment. Material and Methods: This case series was aggregated from patients admitted to the emergency ward, with a diagnosis of mild to moderate ARDS with impending cytokine release syndrome (CRS). Results: These 10 patients were treated with antiCD6 monoclonal antibody, Itolizumab as it had been given emergency use approval for critically ill patients on CRS. Of the 10 patients, 8 received Itolizumab on day 2 while 2 received it on day 1. Nine out of ten patients recovered and were discharged, while one patient died. Patients' progress was monitored by daily evaluation of patients' CRP and cytokine (IL-6) levels, LDH, and clinical and radiological assessment. All 10 patients were observed for oxygen delivery parameters including days of ventilation support, and total oxygen delivery. Conclusion: The administration of antiCD6 monoclonal antibody, itolizumab early has shown to reduce the duration of ventilation support to 5.4 days, total oxygen requirements to 12 days, and hospital stay to 13.3 days. [ABSTRACT FROM AUTHOR]